Patients' Bill of Rights in the United States

The U.S. Patients' Bill of Rights includes the right to privacy not only during medical examination and treatment, but of medical records. | Source

Why a Bill of Rights for Patients?

Over the course of the past 40+ years, different health and medical professional associations have developed and adopted a Patients' Bill of Rights. The Patients' Bill of Rights establishes ethical protocols for how medical and health professionals should interact with patients. Even though physicians enjoyed god-like status, the truth is that they perform a service -- a paid service -- and those people who utilize those services have a right to expect to be treated with dignity and respect.

The initial Patients' Bill of Rights was established in 1973 by the American Hospital Association (AHA). It was then revised in 1992 to include additional rights and better define the details of all patients' rights.

Patients have the right to examine their health care records unless restricted by law. | Source

Brief History of the Patients' Bill of Rights

As stated above, the initial Patients' Bill of Rights was established in 1973 by the American Hospital Association (AHA). It was then revised by the AHA in 1992 to include additional rights and better define the details of all patients' rights.

In 1995 the Association of American Physicians and Surgeons, or AAPS, adopted its own Patient Bill of Rights, termed "freedoms" that state the groups' stand on protocols between physicians and patients and also between physicians, patients and health insurance plans.

For forty years, Sen Edward Kennedy, D-Mass., championed the cause of health care in general, always believing that the individual citizen had a right to the same health care and health care coverage as those enjoyed by U.S. senators.

In 1991 Kennedy joined with 30 other co-sponsors for Patient Bill of Rights legislation. This legislation and one sponsored by Rep. Charles Norwood, R-Ga., both become mired in Senate and House committees and never found their way into federal law books.

Attempts by Sen John McCain, R-Ariz., and others in both 2001 and 2003 to pass a Bipartisan Patient Protection Act that would give patients the right to sue health care providers based on denied care died in the Senate each time. A similar effort by Sen. Barbara Boxer, D-Calif., in 2004 died in committee.

In 2006 legislation was passed on the federal level that health care insurers must provide coverage of mental health services to the same extent as services for physical health. This coverage came into effect Jan. 1, 2010.

Health care facilities must adhere to legally valid advanced directives such as Living wills and durable power of attorney to the extent the law and hospital policy allows. | Source

The Patient Protection and Affordable Care Act

On March 23, 2010 the Patient Protection and Affordable Care Act was signed into law by President Barack Obama. This legislation has been the topic of much debate, both prior to its passage and since. Often referred to as "Obamacare," the Patient Protection and Affordable Care Act is generally called simply the Affordable Care Act, relegating the patient protection of the law into a dusty corner.

The importance of these now federally-regulated patients' rights should not be underestimated. Previous to this law's passage, patients may have rights conferred to them through the AHA and AASP, but little to no opportunity to defend those rights if they were violated.

The Patient Protection and Affordable Care Act offers rights and protections to patients not only in interactions with physicians and medical facilities, but also with health insurance providers (see table).

Separating this law from the politicians and politics of it, let's consider rationally where much of the public buzz comes from in opposition to the Patient Protection and Affordable Care Act; the health insurance industry. Wendell Potter, former Cigna senior executive turned whistleblower, shared the lengths the insurance industry would go to to prevent profit increases, including but not limited to using front groups to spread the anti-reform agenda. The front groups would not be directly associated with the insurers, but would be directed and paid by them.

These front groups were successful in prohibiting earlier attempts at passing a national Patient Bill of Rights.

Right to Not Be Kept Waiting, to Seek Second Opinion

Most Recent Additions to the Patients' Bill of Rights

Insurance coverage will be available to people with pre-existing medical conditions, including children age 19 or younger

The right to choose your own doctor within an insurance plan's network of providers

Lifetime limits on coverage will be eliminated

Parents can keep their adult children up to age 26 on their health insurance plans

You can obtain emergency services at a facility outside your network without incurring out-of-network fees or charges

By the end of 2013, limits on annual health benefits will be eliminated

The health insurance company must spend at least 80 percent of your premium fees for your health care, the not insurance company's overhead and administrative costs

Insurance companies will have to publicly announce and justify increases in premiums

You have the right to ask your health insurance provider to reconsider a denial of payment, termed an "internal appeal"

The Affordable Care Act that became law in 2010 updated the Patients' Bill of Rights and will continue to do so over the next few years as the law achieves full implementation. These additions to the Patient Bill of Rights is current to Feb. 6, 2012.

How the Patients' Bill of Rights Benefits You

You no longer have to accept assignment of a certain physician or health care provider via a health insurance plan. You have the right to refuse treatment, even if it is recommended by your doctor.

You have the right to a second opinion before you make a decision on treatment.

You can seek emergency care when you feel it is necessary and in a medical facility of your choice.

These and many other rights belong to you. Become familiar with them. When a decision by your insurer or physician doesn't feel appropriate to you, read through the Patient Bill of Rights to determine if your situation is covered by one or more of the rights/freedoms.

Don't hesitate to use the services of a patient advocate or a health care attorney or to write your elected federal officials. The Patient Bill of Rights is not a dry, useless document unless you choose to ignore the rights you have.